Decongestive lymphatic therapy for patients with breast carcinoma-associated lymphedema: A randomized, prospective study of a role for adjunctive intermittent pneumatic compression
Identifieur interne : 009897 ( Main/Exploration ); précédent : 009896; suivant : 009898Decongestive lymphatic therapy for patients with breast carcinoma-associated lymphedema: A randomized, prospective study of a role for adjunctive intermittent pneumatic compression
Auteurs : Andrzej Szuba [États-Unis] ; Radha Achalu [États-Unis] ; Stanley G. Rockson [États-Unis]Source :
- Cancer [ 0008-543X ] ; 2002.
Descripteurs français
- KwdFr :
- MESH :
- étiologie : Lymphoedème.
- Pascal (Inist)
- Adulte d'âge moyen, Carcinome, Carcinomes, Combinaisons antigravité, Femelle, Glande mammaire, Humains, Lymphoedème, Compression, Pression, Résultat thérapeutique, Sujet âgé, Sujet âgé de 80 ans ou plus, Système pneumatique, Intermittent, Techniques de physiothérapie, Traitement, Pompe, Physiothérapie, Homme, Tumeurs du sein, Études prospectives.
- Wicri :
English descriptors
- KwdEn :
- Aged, Aged, 80 and over, Breast Neoplasms (complications), Carcinoma, Carcinoma (complications), Compression, Female, Gravity Suits, Human, Humans, Intermittent, Lymphedema, Lymphedema (etiology), Lymphedema (therapy), Mammary gland, Middle Aged, Physical Therapy Modalities, Physiotherapy, Pneumatic system, Pressure, Prospective Studies, Pump, Treatment, Treatment Outcome.
- MESH :
- complications : Breast Neoplasms, Carcinoma.
- etiology : Lymphedema.
- therapy : Lymphedema.
- Aged, Aged, 80 and over, Female, Gravity Suits, Humans, Middle Aged, Physical Therapy Modalities, Pressure, Prospective Studies, Treatment Outcome.
Abstract
BACKGROUND. Disruption of the lymphatic circulation through breast carcinoma-associated axillary lymph node dissection, with or without radiation therapy, reportedly is the most common cause of lymphedema in developed countries. There is no cure for breast carcinoma-associated lymphedema. Although intermittent pneumatic compression (IPC) has been acknowledged as a potential component of the multidisciplinary therapeutic strategy in the treatment of patients with breast carcinoma-associated lymphedema, prospective study of its adjunctive safety and efficacy is required. METHODS. IPC was assessed as a component of the initial therapeutic regimen for newly treated patients with breast carcinoma-associated lymphedema. Twenty-three patients who had not previously been treated for lymphedema were randomized to receive either decongestive lymphatic therapy (DLT) alone or DLT with daily adjunctive IPC. Patients with stable, treated, breast carcinoma-associated lymphedema also were assessed in the maintenance phase of therapy. Twenty-seven patients were randomized either to DLT alone or to DLT coupled with daily IPC. In both studies, objective assessment included serial measurement of volume by water displacement, tissue tonometry to assess elasticity of the skin, and goniometry to measure joint mobility. RESULTS. During initial treatment, the addition of IPC to standard DLT yielded an additional mean volume reduction (45.3% vs. 26%; P < 0.05). During maintenance DLT alone, there was a mean increase in volume (32.7 ± 115.2 mL); with DLT and IPC, there was a mean volume reduction (89.5 ± 195.5 mL; P < 0.05). In both studies, IPC was tolerated well without detectable adverse effects on skin elasticity or joint range of motion. CONCLUSIONS. When IPC is used adjunctively with other, established elements of DLT, it provides an enhancement of the therapeutic response. IPC is well tolerated and remarkably free of complications.
Affiliations:
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Rockson</name><affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Stanford Center for Lymphatic and Venous Disorders, Division of Cardiovascular Medicine, Stanford University School of Medicine</s1><s2>Stanford, California</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Californie</region></placeName></affiliation></author></analytic><series><title level="j" type="main">Cancer</title><title level="j" type="abbreviated">Cancer</title><idno type="ISSN">0008-543X</idno><imprint><date when="2002">2002</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Cancer</title><title level="j" type="abbreviated">Cancer</title><idno type="ISSN">0008-543X</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged</term><term>Aged, 80 and over</term><term>Breast Neoplasms (complications)</term><term>Carcinoma</term><term>Carcinoma (complications)</term><term>Compression</term><term>Female</term><term>Gravity Suits</term><term>Human</term><term>Humans</term><term>Intermittent</term><term>Lymphedema</term><term>Lymphedema (etiology)</term><term>Lymphedema (therapy)</term><term>Mammary gland</term><term>Middle Aged</term><term>Physical Therapy Modalities</term><term>Physiotherapy</term><term>Pneumatic system</term><term>Pressure</term><term>Prospective Studies</term><term>Pump</term><term>Treatment</term><term>Treatment Outcome</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte d'âge moyen</term><term>Carcinomes ()</term><term>Combinaisons antigravité</term><term>Femelle</term><term>Humains</term><term>Lymphoedème ()</term><term>Lymphoedème (étiologie)</term><term>Pression</term><term>Résultat thérapeutique</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term><term>Techniques de physiothérapie</term><term>Tumeurs du sein ()</term><term>Études prospectives</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Breast Neoplasms</term><term>Carcinoma</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Lymphedema</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Lymphedema</term></keywords><keywords scheme="MESH" qualifier="étiologie" xml:lang="fr"><term>Lymphoedème</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Aged, 80 and over</term><term>Female</term><term>Gravity Suits</term><term>Humans</term><term>Middle Aged</term><term>Physical Therapy Modalities</term><term>Pressure</term><term>Prospective Studies</term><term>Treatment Outcome</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Adulte d'âge moyen</term><term>Carcinome</term><term>Carcinomes</term><term>Combinaisons antigravité</term><term>Femelle</term><term>Glande mammaire</term><term>Humains</term><term>Lymphoedème</term><term>Compression</term><term>Pression</term><term>Résultat thérapeutique</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term><term>Système pneumatique</term><term>Intermittent</term><term>Techniques de physiothérapie</term><term>Traitement</term><term>Pompe</term><term>Physiothérapie</term><term>Homme</term><term>Tumeurs du sein</term><term>Études prospectives</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Pompe</term><term>Homme</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">BACKGROUND. Disruption of the lymphatic circulation through breast carcinoma-associated axillary lymph node dissection, with or without radiation therapy, reportedly is the most common cause of lymphedema in developed countries. There is no cure for breast carcinoma-associated lymphedema. Although intermittent pneumatic compression (IPC) has been acknowledged as a potential component of the multidisciplinary therapeutic strategy in the treatment of patients with breast carcinoma-associated lymphedema, prospective study of its adjunctive safety and efficacy is required. METHODS. IPC was assessed as a component of the initial therapeutic regimen for newly treated patients with breast carcinoma-associated lymphedema. Twenty-three patients who had not previously been treated for lymphedema were randomized to receive either decongestive lymphatic therapy (DLT) alone or DLT with daily adjunctive IPC. Patients with stable, treated, breast carcinoma-associated lymphedema also were assessed in the maintenance phase of therapy. Twenty-seven patients were randomized either to DLT alone or to DLT coupled with daily IPC. In both studies, objective assessment included serial measurement of volume by water displacement, tissue tonometry to assess elasticity of the skin, and goniometry to measure joint mobility. RESULTS. During initial treatment, the addition of IPC to standard DLT yielded an additional mean volume reduction (45.3% vs. 26%; P < 0.05). During maintenance DLT alone, there was a mean increase in volume (32.7 ± 115.2 mL); with DLT and IPC, there was a mean volume reduction (89.5 ± 195.5 mL; P < 0.05). In both studies, IPC was tolerated well without detectable adverse effects on skin elasticity or joint range of motion. CONCLUSIONS. When IPC is used adjunctively with other, established elements of DLT, it provides an enhancement of the therapeutic response. IPC is well tolerated and remarkably free of complications.</div></front></TEI><affiliations><list><country><li>États-Unis</li></country><region><li>Californie</li></region></list><tree><country name="États-Unis"><region name="Californie"><name sortKey="Szuba, Andrzej" sort="Szuba, Andrzej" uniqKey="Szuba A" first="Andrzej" last="Szuba">Andrzej Szuba</name></region><name sortKey="Achalu, Radha" sort="Achalu, Radha" uniqKey="Achalu R" first="Radha" last="Achalu">Radha Achalu</name><name sortKey="Rockson, Stanley G" sort="Rockson, Stanley G" uniqKey="Rockson S" first="Stanley G." last="Rockson">Stanley G. Rockson</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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